ROOM RESERVATION FORM INFINITE DIMENSIONAL ANALYSIS KENT 2005 FEBRUARY 9-13, 2005 Please complete and fax to Misty at 330-672-2725 before January 20th, 2005. Rooms will be scheduled on a first come-first serve basis. Keep a copy of this form for your records. A confirmation number will be sent to you. Name: __________________________________________________________ Email: __________________________________________________________ Phone(s): __________________________________________________________ Fax: __________________________________________________________ Reservation dates: Please list your arrival date AND time. Thank you! Arrival __________________________________________________________ Departure __________________________________________________________ Number of people in the room**: 1 • Smoking • Non-Smoking Any special accommodations? (ex: handicap access) No _______ Please type a yes here (on the line) if you would prefer to be placed in the Best Western instead of the Microtel. ** If you are planning on sharing a room with another attendee, please make sure that they know that I am using your contact information for confirmations. Misty Tackett, Graduate Secretary and Office Systems Specialist Department of Mathematical Sciences P.O. Box 5190 • Kent, Ohio 44242-0001 (330) 672-9050 • Fax: (330) 672-2725 • http://www.math.kent.edu/